How much rates vary
Facilitymedian $2,630 · 10th to 90th $955 to $5,129Professionalmedian $1,349 · 10th to 90th $955 to $2,188
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,288.25 Median $4,073.80 Typical High $5,754.40 | Facility | None | $1,288.25 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,288.25 | $1,348.96 | $1,348.96 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,630.27 Median $2,691.53 Typical High $4,570.88 | Facility | None | $2,630.27 | $2,691.53 | $4,570.88 |
BCBS Michigan Setting Professional Modifier None Typical Low $912.01 Median $1,548.82 Typical High $2,187.76 | Professional | None | $912.01 | $1,548.82 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,202.26 Typical High $3,162.28 | Professional | None | $776.25 | $1,202.26 | $3,162.28 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,819.70 Median $2,818.38 Typical High $4,897.79 | Facility | None | $1,819.70 | $2,818.38 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $1,513.56 | Professional | None | $1,071.52 | $1,318.26 | $1,513.56 |
Priority Health Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Priority Health Setting Professional Modifier None Typical Low $776.25 Median $1,148.15 Typical High $1,778.28 | Professional | None | $776.25 | $1,148.15 | $1,778.28 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,548.82 Typical High $7,762.47 | Facility | None | $660.69 | $1,548.82 | $7,762.47 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $1,412.54 | Professional | None | $1,071.52 | $1,258.93 | $1,412.54 |
12 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $645.65 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $645.65 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $263.03 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $977.24 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $194.98 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $128.82 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $912.01 | $954.99 | $954.99 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $645.65 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $645.65 | $676.08 | $676.08 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $263.03 | $269.15 | $269.15 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $977.24 | $1,023.29 | $1,023.29 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $194.98 | $204.17 | $204.17 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $128.82 | $134.90 | $134.90 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $912.01 | $954.99 | $954.99 |
Where Michigan sits
The same service costs 8.3 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Michigan· 31st of 51
$1,349
AK $4,169TX $501
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.